Assessment of the scientific rigour of RCTs on the effectiveness of CBT and GET for ME/CFS: a systematic review (2019) Ahmed et al

Indeed.


Welcome Simon, I hope you enjoy your stay on this forum! *waves*

 

This is one reason mixed MUS studies will likely have few objective outcome measures that might theoretically be used in trials of ME/CFS alone. For example, actigraphy wouldn’t say much about whether an intervention has helped Irritable Bowel Syndrome.

 

What’s the Friedman study?

 

Usually several papers on the one trial are normally seen as one trial rather than the way this paper presents them.

 

Cochrane reviews of CBT and (separately) GET for CFS involve tables like Figure 2 [“Summary of risk of bias of included studies”]. My guess is they don’t agree 100%.

 

I’m not sure of the classification of the PACE Trial recovery paper as “low risk of bias” for “Selective reporting (reporting bias)” given all four outcome measures were changed from the protocol and two of the thresholds were described as post hoc in the 2011 paper.
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They do say the following in the text, but many people may only look at the figure:
Deviations from its protocol are mentioned by O’Dowd et al. (2006) and White et al. (2011, 2013).

 

I'm not happy with the classification of O'Dowd et al. 2006 as having a “low risk of bias” for “Selective reporting (reporting bias)” for the reasons discussed in this post:
https://www.s4me.info/threads/asses...view-2019-ahmed-et-al.9449/page-2#post-167344

They do say the following in the text, but many people may only look at the figure:
Deviations from its protocol are mentioned by O’Dowd et al. (2006) and White et al. (2011, 2013).

 

Sorry I meant Friedberg and the actimeter studies he did:

• Friedberg, F. Does graded activity increase activity? A case study of chronic fatigue syndrome. Journal of Behavior Therapy & Experimental Psychiatry, 2002;33:203-215
• Friedberg F, Sohl S. Cognitive-behavior therapy in chronic fatigue syndrome: is improvement related to increased physical activity? J Clin Psychol. 2009;65:423–42.

I might have overstated that he found an activity limit. If I remember correctly, the second study mostly showed that subjective improvements after CBT are not accompanied by objective improvements in actigraphy. And the first one is just a case study, but it does include the interesting passage:

 

Table 1. Overview of interventions in the included studies.
Table 2. Outcome measures and measuring instruments used.
Table 3. ‘Improvement’ and ‘recovery’ operationalized as a combination of several outcome measures (cut-off scores).

Table 2 includes the following:

These might be useful for people who want to get information quickly on studies, though ideally checked the original papers if one has time.

 

Very minor point:

I have no idea what they are taking about with regards to the Deale et al. study.

 

https://twitter.com/user/status/1151613353422401536

 

https://twitter.com/user/status/1151613858945150976

 

https://twitter.com/user/status/1151628864206102528

 

https://twitter.com/user/status/1151629665808846848

 

https://twitter.com/user/status/1151630469622091776

 

https://twitter.com/user/status/1151631430545551361

https://twitter.com/user/status/1151631718971056129

 

@Adam pwme highlighting on Twitter the time, quoted above, when Sir Simon found the forum useful.